Surgical Treatment Of Pediatric Primary Cardiac Tumors:a Single Center Experience

Background:Primary cardiac tumors in infants and children are rare and mostly benign, surgical intervention is advocated when clinical symptoms or hemodynamic obstruction is present. This study summarizes our surgical experience with pediatric primary cardiac tumors.Methods:Between January2000and September2010,13children (7males and6females, median age87days, ranging from1day to12.3years) with primary cardiac tumors were surgically treated in our institution. Diagnosis was made by prenatal echocardiography in5patients and by2-dimensional Doppler echocardiography in8patients.Results:Surgical resection of primary cardiac tumors was feasible in all patients. Histologic examination revealed rhabdomyoma in4patients, myxoma in3patients, papillary fibroelastoma in3patients (multiple in1), fibroma in2patients and hemangioma in1patient. One patient with a huge rhabdomyoma, died in the third day after surgery because of severe ventricular fibrillation and subsequent low cardiac output. The operative mortality was low (7.7%). At a mean follow-up period of57.7months (ranged12months to85months), all the remaining12patients are in good clinical condition with no tumor-related symptoms. Two-dimensional echocardiography reveals good ventricular function and no tumor recurrence.Conclusions:Surgical resection of primary cardiac tumors in infancy and children is safe and feasible. The operative mortality was low. Heart transplantation or a less complete resection may be a good therapeutic choice when the tumor invades the myocardium extensively. Echocardiography is still the current primary diagnostic modality, whereas computerized tomography and magnetic resonance imaging provide complementary information about intra-and pericardiac masses.